Jay Scott Randell, DMD

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

D11182 Issued in OR

Practice address

530 NW 27TH St
Corvallis, OR 97330-5223

Phone

(541) 766-0123

Fax

(541) 766-6186

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other names 1

• Dr. Jay Scott Yudell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1437231503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 NW CIRCLE BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301462",
            "telephone_number": "541-257-2006",
            "fax_number": "541-257-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NW 27TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305223",
            "telephone_number": "541-766-0123",
            "fax_number": "541-766-6186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1112 NW Circle Blvd",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973301462",
            "country_code": "US",
            "telephone_number": "541-257-2006",
            "fax_number": "541-257-2007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDELL",
        "first_name": "JAY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "13269",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "202368",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "044249",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "OR",
            "license": "D11182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "YUDELL",
            "middle_name": "SCOTT",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessaca Ramos
• Ovidia L Ramos
• Mark Edmond Rampton, MD
• Christian M Ramseier
• Bruce Ramsey, MD
• Jasmine Idela Rangel Manriquez
• Sherri Ann Rankin
• Laurel Ransom
• Evangelina Y Rapoza
• Moein Rasekh

• Public Health Dentistry in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Public Health Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.